Condition: Patches of hair loss

Patches of hair loss are caused by alopecia areata, an autoimmune condition where the immune system attacks the hair follicles, causing the hair to fall out in clumps.

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What are patches of hair loss?

Patches of hair loss are due to an autoimmune condition called alopecia areata. The condition can affect any area of the body but most commonly affects the scalp. There are several classifications of the condition that describe the amount of hair loss, from diffuse alopecia areata (thinning hair) to alopecia areata totalis (loss of all hair on the scalp).

Alopecia areata is the second most common hair loss condition behind, female pattern baldness and male pattern baldness. Anyone can be affected by it, but you are at greater risk if you have a family history of the condition or if you or any of your family have an autoimmune disorder, such as diabetes, lupus or thyroid disease. While the condition doesn’t typically harm physical health, it can cause psychological and emotional stress.

What are the symptoms of patches of hair loss?

In most cases, alopecia areata causes the hair to fall out in patches, usually around the size of a 10-pence piece. However, the shape and size of these patches could be bigger or smaller, or more irregular depending on the severity of the condition.

If you have alopecia areata of the scalp, you may also notice hair loss from other areas such as your eyebrows and eyelashes, and any area of body hair or facial hair in men.

It’s rare to have other symptoms in the patches of hair loss, but some people may notice that the skin itches, is red, purple, brown or grey in colour, develops visible hair follicles, has black dots, short hairs that are thicker at the ends, or white hair growth.

If you have alopecia areata, you may also see that your nails develop dents or pits which makes the nail surface feel gritty or crumbly.

What causes patches of hair loss?

Alopecia areata is an autoimmune condition. In autoimmune conditions, the body’s natural defences can’t distinguish between normal cells and foreign cells, causing it to mistakenly attack healthy cells. In alopecia areata, the immune system starts to attack your hair follicles, causing your hair to fall out in clumps.

It’s not yet understood why the immune system malfunctions in this way, but it could be due to genetics, certain conditions such as Down’s syndrome, thyroid disease, vitiligo and lupus, or vitamin and mineral deficiencies. It’s thought that it may also be triggered by factors including stress, illness and injury.

How are patches of hair loss diagnosed?

At OneWelbeck, our consultant dermatologists can make a diagnosis of alopecia areata by doing a physical examination of your scalp and any other areas of hair loss, taking a family and medical history, and asking questions about your symptoms, such as when they started.

They may also run some tests to get a deeper understanding of your particular condition and symptom patterns. These may include taking a scalp biopsy, collecting a sample of hair, and blood tests.

How can patches of hair loss be treated?

There is currently no cure for alopecia areata but treatments can help control your hair loss. A large number of treatment options are available, including lotions that are applied to the patches, injections into the patches, and topical or oral immunotherapy to suppress the immune system. You may also be given anti-inflammatories in the forms of scalp applications, prp injections and tablets.

Your consultant will discuss your options with you and recommend the best possible treatment depending on the extent of your hair loss.